We all know how it feels to discover that we've been lied to. Have you considered the possibility that you have been the victim of an elaborate online deception? Members of online social communities have fallen victim to deceitful members who prey upon their heart with their carefully woven webs of deceit. Find out how you can protect yourself from this type of scam.

For decades, people have heard of Munchausen syndrome, a disorder characterized by people taking extraordinary measures to fake illnesses or psychological trauma for the sole purpose of attracting attention and sympathy from others. Munchausen sufferers will do almost anything to validate the delusion of their illness. Another variation of this disorder is Munchausen by proxy, in which people physically or psychologically harm loved ones to gain attention and sympathy. In more recent years, a newer variation of this disorder has been noted to infect online communities.

Internet traffic has exploded over the past two decades, providing users with instant access to information and networking with others. With the increasing number of online users and formation of online social communities and support groups, beginning in the 1990's there have been increasing reports of users who have deceived internet forum participants by portraying themselves as gravely ill or as victims of violence or psychological trauma. The internet was made for such fakers. Arming themselves with medical knowledge obtained through hours of perusing the internet, these users create intricate online stories of prolonged suffering and even death which end up being nothing more than fabrications.

A pattern for this new Munchausen variation was identified in 1998 by Dr. Marc Feldman, a clinical professor of psychiatry at the University of Alabama, and an expert on Munchausen syndrome and factitious disorder. Dr. Feldman coined the term "Munchausen by Internet" in an article published in 2000, "Munchausen by Internet: Detecting Factitious Illness and Crisis on the Internet".

This disorder is essentially the same as the better known Munchausen syndrome, with the main difference being that people carry out their deceptions online. "On the Internet," Feldman explains, "it's very easy to fake. All you have to do is click and you go to another disease site. You can become an expert on anything in 30 minutes by visiting Google." At first, Munchausen by Internet was most common in online medical support groups, but variations of it now show up anywhere that people socialize online, such as social networking sites, blogs, forums, discussion groups and chat rooms. The fictitious stories can take months and even years to play out.

These deceivers are usually not newcomers to the site, but instead have already begun to weave their story of deception, making online friends while they are setting the stage. They portray themselves as incredible, wonderful and charismatic people. The drama unfolds in different ways but usually involves a sudden revelation by the writer that they have contracted a serious illness.

They may have already disclosed lesser challenges they have previously faced, just to ensure they have sympathetic listeners. All the time while weaving their web of deception, they are bravely coping with whatever tragic situation or string of situations they are facing. They go on to provide details of their declining situation, including hospitalizations, doctor appointments, treatments, etc.

Many times their condition/hospitalization will preclude them from using a computer, thus making it possible for another fictitious character to enter the picture and post in their place. This is usually a close friend or family member(s). They refrain from divulging their location or contact information such as telephone number. Most of these liars end up having shocking, sudden, or especially poignant deaths which is relayed by someone close to them. There may be a miraculous recovery, followed by relapses and more drama..... and prolonged suffering for both them and their followers. It will go on and on........

Put yourself in the place of one of the targeted "victims." At first, you are greatly saddened by the predicament of which the member posts. You want to help. You may even offer support. You find yourself drawn into the drama as it continues to unfold with layer upon layer of catastrophic detail. Slowly, you notice the story contains more and more discrepancies. You tend to make excuses for these inconsistencies, thinking the faker's thought processes may be clouded by the medications and illness. As the lies continue to pile up, you slowly come to the realization that you've "been had". And on that day, you feel like a total doofus. There is an overwhelming sense of betrayal as you realize you have been lied to, used, and manipulated. You may even feel angry at the perpetrator.

Once you have been fooled by one of these liars, looking back you will see more and more inconsistencies and red flags in their story. While the stories vary greatly, the behavior of these people is consistent enough that Dr Feldman has described seven "clues to detection of false claims" based on numerous case studies.

The posts consistently duplicate material in other posts, in books, or on health-related websites;

The characteristics of the supposed illness emerge as caricatures based on the individual's misconceptions;

Near-fatal bouts of illness alternate with miraculous recoveries;

Claims are fantastic, contradicted by subsequent posts, or flatly disproved (e.g. a call to the hospital reveals that there is no such patient);

There are continual dramatic events in the person's life, especially when other group members have become the focus of attention;

There is feigned blitheness about crises (e.g., going into septic shock) that will predictably attract immediate attention;

Others apparently posting on behalf of the individual (e.g., family members, friends) have identical patterns of writing.

What motivates people to do this? Dr. Feldman states that the clue to their motivation "may lie in the power granted by online communities to quantify the sympathy for an illness or the shock of a death via comment boxes or replies to a journal thread." These fakers can sit back and read the comments of support from numerous readers who are following the created saga as their illness progresses. They relish the thought that their words are eliciting sadness and tears. "It feeds the desire of the narcissist and provides the lonely with the attention that they may never previously have known."

We know that this type of behavior will only increase as others take their lies to the internet. So what can we do? How do we respond? These people are seeking attention, so indifference is one of our defense tactics. As nurses on a nursing website or in any real-life situations we should of course be compassionate and supportive of others in genuine need. Most people online and in real life, are usually telling something close to the truth most of the time. They may embellish their story a bit, but nothing close to what we are referring to here.

As an online nursing community, we are susceptible to being used by Munchausen by Internet sufferers, as well as deceptive posters in general. Because we are nurses, we are very caring people. We are trained to help folks. People like this know how to prey on others......they know all the right buttons to push. It is easy for us to get caught up in this type of scam. This is a lesson for all of us to learn. We cannot always trust what people post online. We should be alert and question the veracity of online assertions and balance empathy with circumspection. You must guard yourselves against getting sucked in. It is also important to not provide personal information to members you do not know.

If you suspect a member is posting deceitful information with the characteristics of this disorder, it is best to report your suspicions to the Administrators of this site or the site on which you are participating. They will take actions to investigate the matter. Remember......you are dealing with someone who is mentally ill, and their response to confrontation is unpredictable. Upon discovery of false posting, most Munchausen by internet scammers leave after possible denials. They search to find another online group on which they can prey.

Let me leave you with one last thought. We have always heard the phrase "If it seems to be too good to be true, it probably is." In this case... If it seems too bad to be true, it probably isn't.

tnbutterfly has been in nursing for more than 30 years, with experience in med-surg, pediatrics, psychiatrics, and disaster nursing. She is currently a parish nurse.....a position which she has had for the past 15 years.

Great article! Very well done! Thanks for all the details, this is wonderful information for everyone to read. You never know who is behind the other end of the keyboard.

It would be great if everyone can share any experiences with this disorder.

Jan 30, '13

munchausen by internet is preferrable to munchausen by proxy...

Jan 30, '13

tn, thanks for this article. I think a lot of us were not even thinking about this possibility regarding a member here. I had thought possible inconsistencies in posts were a consequence of a particular disease progression. But thank you for watching over everybody here. I simply was not going to fact hunt through all the posts, so I would not have known. Surprisingly when I read your notice, I was not at all mad - I guess it's just a sign of the times.

I would not be one to give out my personal info to this person, and, I have never had a facebook account, etc. I like to help and support, but there is a line not to cross. I think the older nurses here understand that the "interweb" LOL is often for fools. The younger ones who have grown up with it are a lot more trusting.

Edit: I have to add that many members here have had horrible medical problems and I will continue to support them.

I would not be one to give out my personal info to this person, and, I have never had a facebook account, etc. I like to help and support, but there is a line not to cross. I think the older nurses here understand that the "interweb" LOL is often for fools. The younger ones who have grown up with it are a lot more trusting.

Edit: I have to add that many members here have had horrible medical problems and I will continue to support them.

I agree with this. I try to be very cautious with online dealings.

And I also agree that we should continue to show compassion and support to those who truly need it. We just have to develop a keen sense of discernment.

Jan 30, '13

I've been a member/regular poster of various parenting message boards for over 15 years (since I became pregnant with my oldest child). I've seen a lot of shenanigans like this, including fictitious illnesses of members, fictitious illnesses of members' children, fictitious pregnancies (and subsequent stillbirths/miscarriages), and even one person who totally Catfished - created a whole false identity, with photos she had swiped, and made up a marriage and two children (children's photos were also swiped). She posted alongside this group of women for several YEARS under her false identity until she was outed. I know of another woman (who was a stay-at-home-mom, no medical background, although medically knowledgeable) who stole another poster's identity (the poster was a physician) and started posting on medical advice boards.

As a result of seeing stuff like this firsthand, I have a healthy dose of skepticism of anyone I "know" online whom I haven't met in person.

This is why it bothers me when students post here, asking to interview someone here, as part of a class assignment to interview a nurse.

Jan 30, '13

I actually had this happen to me it wasnt on the internet tho

when I was in nursing school working at this nursing home one of the employees fooled EVERYONE telling us her daughter passed away we all gave money and compassion and we really came together & extended our condolences no one really thought to question it because the lady had moved to our state from Kansas (I live in fl) so she had no fam here so of course none of us could go to the funeral

one day my boss got the strangest phone call...from the lady's daughter! That was supposed to be dead! That freaked her out! My boss never mentioned anything like "hey aren't u supposed to be dead?" Or anything she was just like "um ur so&so? Um do u have a sister?" The ladies daughter was like "no I'm the only child" & my boss just took the phone call like normal & said "no blah blah isn't here today"

Who lies about their child passing away? It was crazy! She really played everyone at my job

Jan 30, '13

tn, thanks for this article. I think a lot of us were not even thinking about this possibility regarding a member here. I had thought possible inconsistencies in posts were a consequence of a particular disease progression. But thank you for watching over everybody here. I simply was not going to fact hunt through all the posts, so I would not have known. Surprisingly when I read your notice, I was not at all mad - I guess it's just a sign of the times.

Wait, what? So the OP is in response to something that happened here?

Jan 30, '13

GREAT article, tn. Definitely makes you think. This world is a scary place.

Jan 30, '13

I'm in nursing school and there is another student who either has the world's worst and most devastating fortune, or has factitious disorder.

Back in the late 90's I was part of an online internet forum. One of the more popular young women using the forum staged her own death. (She wasn't really dead, as everyone soon found out, but had been posing as a much younger version of herself - complete with photos - and had gotten into it a bit too far).

Jan 30, '13

p.s. I don't think this is a sign of the times so much as the internet is just another mechanism for people who would be doing this anyway, offline. The behavior itself is nothing new.

Yes, this is something that happened on allnurses.com. We were suspicious, we investigated, we cleaned house. This person was banned to protect the rest of the membership from their sick game.

Jan 30, '13

We've been discussing this extensively on another forum I participate in -websleuths.com. It came to light in regard to a thread/story which has blown up over there. In this case, the mother of a young woman who took her own life has spun this gigantic story about stalking/murder/porphyria/CO poisoning.
Then there is the family who was on Extreme Makeover:Home Edition whose mother claimed her two girls had some strange malady, and this story has totally unraveled. (This is, I believe, a case of MBP which has an internet presence)
There's a difference, I suppose between the person who seeks ATTENTION and the person who seeks MONEY for their supposed affliction.
Anyway, I work in a peds hospital, and the whole MBP thing is so evil.